A patient’s haunting words inspired this pair of digital art pieces, Rusty and Wooden. Before starting medical school, I worked as a medical scribe in oncology. Several of my patients were many years in remission for cancer and came back to our clinic for annual follow-ups. The patient who prompted this art was KR, a woman in her 60s who was in decades-long remission for breast cancer. Her follow-ups tended to be short and primarily social—the oncologist checked in about the patient’s husband, children, and upcoming retirement plans. The last visit I scribed for KR, though, touched on a new topic: her new osteoarthritis (OA) diagnosis. Her knees had been stiff and painful for months, and she decided to see a rheumatologist. She described her relief at finally having a diagnosis replace her suspicions and uncertainty.

She took a deep breath and dried her eyes. Then she looked at me and said, “I wish I could explain just how hard it’s been.”

The oncologist nodded and asked, “The stiffness and pain? I’m so sorry.”

KR shook her head. “No. I mean, yes, that is terrible. I can’t walk [my dog] Charlie anymore. But the hard part has been how normal I look.”

KR said the “invisibility” of her OA felt like a constant weight on her shoulders. She felt constantly judged by people who could not see, and thus did not know about, her condition. She caught people staring and shaking their heads when she used the “disabled person” parking spots. Trips to the bathroom felt miles and hours long. Even her husband sometimes had trouble grasping just how difficult and painful moving her knees had become. KR looked at me and said, “I wish sometimes that people could see my arthritis and see how it feels for me. I think that would help them understand a bit better.”

These 2 digital art pieces are my attempt to fulfill KR’s wish. I used her descriptions of her OA, that flexing her knees felt like moving rusted or wooden joints. Rusty depicts a knee rusted over, with the rust spreading further down (Figure 1). Wooden shows a pair of knees hewn out of tree trunks (Figure 2). Together they aim to visualize and externalize KR’s experience and to provoke thought about the sometimes-forgotten weight of having a painful, life-limiting condition that is invisible.

A knee with visible rust on the skin. The rust is spreading through the entire limb. Brian Robert Smith, Rusty, 2022, digital art.

A pair of tree trunks shaped like knees. Brian Robert Smith, Wooden, 2022, digital art.

The initial draft was made in Affinity Designer, then iterated through the artificial intelligence program Midjourney with custom parameter weighting. Afterward, the output was further processed in Affinity Designer.